Individual provider Active NPI

Hikari Daniel Mizukami, DPT

  • Physical Therapist
  • Renton, WA
National Provider Identifier
1437558723
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60484211 Issued in WA
Practice address
17800 Talbot Rd S
Suite D
Renton, WA 98055-5740
Phone
(425) 277-9096
Fax
(425) 277-1206
NPI assigned
Aug 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60484211 WA Primary

Addresses

Primary practice location

17800 Talbot Rd S
Suite D
Renton, WA 98055-5740

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other names 1

  • Daniel Mizukami Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141114001814 WA Practitioner - Physical Therapist in Private Practice 3072735653 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Washington School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellevue Sports and Spine Physical Therapy P S.Group PAC ID 8123910379, 5 clinicians
Lake Washington Physical Therapy LLCGroup PAC ID 3476679812, 54 clinicians
Houghton Physical Therapy LLCGroup PAC ID 3577857903, 9 clinicians

Practice addresses (Care Compare)

1975 112TH Ave NE
Suite 100
Bellevue, WA 98004-2942
Phone (425) 450-9801

6704 NE 181St St
Suite 101
Kenmore, WA 98028-4890
Phone (425) 419-4363

6710 108TH Ave NE
Suite 100
Kirkland, WA 98033-7050
Phone (425) 979-7445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60484211WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Jun 22, 2015 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince Jun 22, 2015 Accepting new patients
Bellevue Sports & Spine Physical Therapy PS Physical Therapist CurrentSince Mar 20, 2021 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

1975 112th Ave NE
Ste 100
Bellevue, WA 98004
Phone (425) 450-9801

1188 106th Ave NE
Ste 100
Bellevue, WA 98004
Phone (425) 454-4864

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

7650 SE 27th St
Ste 112
Mercer Island, WA 98040
Phone (206) 230-8320

17800 Talbot Rd S
Ste D
Renton, WA 98055
Phone (425) 277-9096

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1437558723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 TALBOT RD S",
            "address_2": "SUITE D",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555740",
            "telephone_number": "425-277-9096",
            "fax_number": "425-277-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZUKAMI",
        "first_name": "HIKARI",
        "middle_name": "DANIEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-22",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60484211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIEL",
            "last_name": "MIZUKAMI",
            "credential": "DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.